The Postnatal bits people forget to tell you

So the baby is born, he/she is in your arms and you are wondering about the miracle of life and how this baby ever grew and lived inside you for this long. Not long after you birth the placenta – the tree of life and the many things that people forget to tell you about begin.

Firstly you feel as though you have been hit by a truck. Every muscle in your body has forgotten how to function and as though it has just ran the forty marathons in one day. Essentially birth of any sort is like this. You have just been through a huge life change and if you have been labouring you have used many of your muscles in moving, mobilising and getting your baby into a good position as well as exercising your uterus to guide your baby out. If you have had a caesarean then you have just had major abdominal surgery which is a huge deal and your body is trying hard to recover and heal. Give yourself time to rest, have plenty of fluids, eat well and don’t push yourself too early.

This is time for you to enjoy, put your feet up and focus on your newborn. There is no rush for anything else and this is where your partner or family come in to help you with anything you need. For some women this feeling doesn’t last long whereas for others it could be a few weeks depending on the type of birth you had and how your body chooses to respond.

Secondly there are the afterpains. These are more common with the more pregnancies/births you have. Its purpose is to reduce postnatal bleeding and return the uterus to its normal cricket ball size barely palpable behind your pubic bone. Sometimes these are linked to breastfeeding in first day but the good news is these should subside and ease over a few days. Simple analgesia (Paracetamol or ibuprofen), a hot water bottle or a bath are fabulous remedies for these pesky period like pains. Ensuring your bladder is emptied regularly is also incredibly important as if you have a full bladder it pushes the uterus to one side meaning that your body produces even more oxytocin to remain contracted and reduce bleeding for you. Nature is wonderful but it may be telling you it’s time for the first wee.

That first wee regardless of how your baby was birthed will be scary. You may be wondering how painful it will be if you have stitches. You may be wondering if it’s going to burn after having a catheter in all day for an operative birth. It’s always a big deal no matter how many times you’ve had a baby. Drinking plenty of clear fluids helps to dilute your urine which then reduce any potential stinging or burning you may experience. It’s essentially like adding more water to squash and diluting it – you don’t want heavily concentrated salty urine the first time you go. Using a small amount of water or urinating into the shower for the first time can help reduce your anxieties and make you feel more at ease about going. If you are in a hospital your midwife will however want you to measure your first two wee’s (ideally the first within 6 hours of birth or the catheter being removed) to check that you haven’t had any urinary problems following birth.

Next the first bath/shower worries and concerns. When you first get out of bed it sometimes looks like world war three has happened with the amount of blood that appears to drip out on the way to the bathroom.This bleeding will reduce as time goes on but an last up to 6 weeks.  It’s your first time out of bed and your entire body weak and sometimes it can make your head feel a bit fuzzy. Ensuring you have eaten and drank well will help to reduce this fuzzy feeling. You may also need assistance if you have had a heavy bleed following birth as you may feel quite lightheaded. You won’t want to directly apply any shower products onto any area (abdominal or vaginal) which has stitches on but you can absolutely use your everyday showering products on the rest of your body as the shower will dilute your products. You can always rinse down afterwards if you think any showering product has got near your stitches. You can bath if you want to and this might be really soothing on your muscles or stitches a few days following birth. I would just avoid applying any perfumed products around the vaginal area as you really don’t want thrush if you can help it in the postpartum period.

There is also the ‘jelly belly’ looking slightly pregnant still look. Very fashionably shown by Kate Middleton after birth showing the reality of a normal postpartum belly. Abdominal divarication is a splitting of your abdominal muscles during the pregnancy. It is incredibly normal and is due to accommodating your growing baby for nine months and having lots of the softening hormone progesterone. It will improve with time (about 6-8 weeks) especially if you have had a vaginal birth. Not undertaking any sit up’s or abdominal strength exercises are good to prevent any muscle damage.

Doing some ‘pulling in’ exercises of your tummy muscles (take a deep breathe in, suck your tummy in to your spine like you would put a corset on or when you have photos taken, breathe out but keep your tummy sucked in) at the same time ‘pull up’ your pelvic floor. Your pelvic floor is linked to your deep core muscles and will help tone everything again. It is normal regardless of the way your baby is born to feel as though your pelvic floor is doing nothing to begin with – it has just carried placenta, waters and your baby for nine months. It will need some recovery time and gentle encouragement to feel normal again. Every time you feed your baby, try a few and build it up as it begins to feel more comfortable and stronger.

The final thing everyone forgets to tell you about is that your bowels need to function again. I have never met a woman that hasn’t told me about this fear. If you’ve had stitches the worry is you’ll break them (Little piece of reassurance – I have never known anyone ‘break’ them from opening their bowels). If you have had a caesarean then essentially you have had major abdominal surgery, had your bowels seen by doctors, been immobile for 24 hours and had a lot of medication which can cause constipation. Either way the fear is there. Once again staying hydrated will reduce the risk of constipation, some fruit juice is usually a good laxative and contains vitamin C which will boost your immune system as well. Plenty of fibre, fruit and vegetables will also help soften the stools naturally and getting up and mobile when possible will also aid bowel motion. If you have any laxatives then you absolutely can use them but be aware you don’t want to cause diarrhoea either especially if your dash to the toilet is more of a snail’s pace in the initial postnatal period.

If you are really concerned about going for that first time then you can put a maternity pad on your hand place the edge of it near your anus and have your hand supporting your perineum (the part in between your vagina and anus) with the pad in between. This will make no physical difference to you going but it will give you the mental reassurance that you can do this, that you are providing support to yourself and that it will be okay. Again almost every woman has said it’s not as bad once it’s over – it’s just the build up of worries.

But of course this is all made worth it by that newborn baby that is finally in front of you. Yes the hard work and long nights have started, yes the continual feeding is there but that baby you have bought home – that baby is all yours and they are completely worth it!

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